Provider Demographics
NPI:1508633066
Name:JASMYN BLANCAFLOR DMD PLLC
Entity Type:Organization
Organization Name:JASMYN BLANCAFLOR DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JASMYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLANCAFLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:509-499-9425
Mailing Address - Street 1:5229 38TH AVE SW UNIT C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-2870
Mailing Address - Country:US
Mailing Address - Phone:509-499-9425
Mailing Address - Fax:
Practice Address - Street 1:1911 QUEEN ANNE AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2549
Practice Address - Country:US
Practice Address - Phone:509-499-9425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental